Provider Demographics
NPI:1376637991
Name:LAROCCA, VITO SAVERIO (MD)
Entity Type:Individual
Prefix:
First Name:VITO
Middle Name:SAVERIO
Last Name:LAROCCA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:78 TODT HILL RD
Mailing Address - Street 2:SUITE 111
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10314-4528
Mailing Address - Country:US
Mailing Address - Phone:718-442-3232
Mailing Address - Fax:718-442-3989
Practice Address - Street 1:78 TODT HILL RD
Practice Address - Street 2:SUITE 111
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10314-4528
Practice Address - Country:US
Practice Address - Phone:718-442-3232
Practice Address - Fax:718-442-3989
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-03
Last Update Date:2008-08-19
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY152318207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00885305Medicaid
NY83A772Medicare PIN
NY00885305Medicaid